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Individual

ANDELL Y PHILLIP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1540 INTERNATIONAL PKWY STE 2000, LAKE MARY, FL 32746-5096
(352) 502-4923
(352) 504-0241
Mailing address
8810 SW HIGHWAY 200 UNIT 124, OCALA, FL 34481-7822
(352) 502-4923

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
239577
FL
376K00000X
Nurse's Aide
166697
FL

Other

Enumeration date
02/02/2019
Last updated
12/01/2023
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